Coram Cvs/Specialty Infusion Services

LBN: Coram Alternate Site Services Inc
Coram Cvs/Specialty Infusion Services is an health care organization with primary practice located at 12310 World Trade Dr Suite 100, San Diego CA 92128-3793. The organization recently has 11 registered licenses in different health care specialties including Agencies / Home Health, Agencies / Home Infusion, Ambulatory Health Care Facilities / Infusion Therapy, Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Parenteral & Enteral Nutrition, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Home Infusion Therapy Pharmacy, Suppliers / Mail Order Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Home Infusion Therapy Pharmacy is the primary health care specialty. Coram Alternate Site Services Inc can be contacted via phone (858) 576-6969, or through Lacavich, Tricia via phone (314) 306-3255.

Contact Information

Primary practice address
12310 World Trade Dr Suite 100 San Diego CA 92128-3793
Phone: (858) 576-6969
Fax: (858) 974-6606
Website:
Map and Directions
Authorized official contact:
Name: Lacavich, Tricia
Phone: (314) 306-3255

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X 0800429 California
Agencies / Home Infusion 251F00000X 0800429 California
Ambulatory Health Care Facilities / Infusion Therapy 261QI0500X California
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X PHY50273 California
Suppliers / Parenteral & Enteral Nutrition 332BP3500X PHY50273 California
Suppliers / Pharmacy 333600000X PHY50273 California
Suppliers / Community/Retail Pharmacy 3336C0003X PHY50273 California
Suppliers / Compounding Pharmacy 3336C0004X PHY50273 California
Suppliers / Home Infusion Therapy Pharmacy 3336H0001X PHY50273 California
Suppliers / Mail Order Pharmacy 3336M0002X PHY50273 California
Suppliers / Specialty Pharmacy 3336S0011X PHY50273 California

Profile Details

NPI number 1790734036
LBN Legal business name Coram Alternate Site Services Inc
DBA Doing business as Coram Cvs/Specialty Infusion Services
Authorized official Lacavich, Tricia
Entity Organization
Organization subpart 1 Yes
Enumeration date May 5th, 2006
Last updated Mar 7th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790734036 NPPES
Other 0522311 NCPDP
MEDICAID PHA409320 NCPDP
Other 101225 NCPDP
Other 0800429 NCPDP
Other PHY50273 NCPDP

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